At just 50 years old, Dr. Alice Howland has achieved tenure at Harvard University, published dozens of articles, given speeches all over the world, written and published a book with her husband, John, and made a real and meaningful impact on the field of psycholinguistics. In her personal life, she has raised three children (one a doctor, one a lawyer, one pursuing acting in Los Angeles), has a successful marriage, and enjoy a close family-like relationship with her colleagues. Alice takes great pride in her status as an independent, intelligent, physically-fit, and successful woman. Her diagnosis of early-onset Alzheimer’s is unexpected and, in her mind, transforms her from “Alice Howland, brave and remarkable hero” to “Alice Howland, Alzheimer’s victim.” Over the course of this book, Genova illustrates, in painful detail, the myriad ways in which Alzheimer’s strips sufferers of their identities, leaving them helpless to stop it or reinvent themselves as they lose their self-awareness.
For over 25 years, Alice has worked as a research scientist and professor, achieving the important career milestone of tenure at the prestigious Harvard University. This success is an important part of her personal identity, but it’s also the first to fall victim to Alzheimer’s. As Alice begins to really struggle with retaining memories and doing her work, she begins to feel “like a fraud posing as a Harvard professor.” For Alice, this is the real beginning of the end of her professional identity because it shows she is beginning to doubt herself. Alice, however, is not the only one to notice that she is struggling, which is reflected in her below-average student evaluations. As a result, she is forced to give up teaching and lecturing, leading her to feel “like the biggest part of her self, the part she’d praised and polished regularly on its mighty pedestal, had died.” Furthermore, she is gradually “cast out” by her colleagues, leaving her feeling “bored, ignored, and alienated,” no longer respected as a professional or as a friend. This marks the true end to her identity as distinguished Harvard professor.
Perhaps the most tragic element of having Alzheimer’s is that those who suffer from it gradually forget their own family, as Alice finds out all too soon. As Alzheimer’s ravages her mind, she eventually loses her identity as wife and mother as her parental roles are reversed with her children. Alice and John have had a long marriage together, despite “bottomless argument[s]” over their daughter Lydia’s acting and time spent apart due to work. However, as she struggles with Alzheimer’s symptoms, Alice notices that John seemingly “[can’t] bear to look at her,” highlighting his struggle to see her as his wife and not a helpless Alzheimer’s patient. Alice has enjoyed her role as a mother and is eagerly anticipating the birth of her two grandchildren so she can become a grandmother. However, her Alzheimer’s flips the script and leaves her dependent on her children in much the same way they once depended on her. This is shown by the way they “[talk] about her as if she weren’t sitting […] a few feet away,” making decisions about how to care for her as she loses the ability to help herself. Alice’s loss of independence thoroughly strips her of her capacity to fulfill her roles as a wife, mother, and grandmother.
Beyond her career and family, Alice’s slowest—and most complex—loss of all is that of her self-awareness. Her sense of self outlives her ability to recognize her children, but she is powerless to keep it safe from the ravages of Alzheimer’s. Alice considers the life she’s lived as “strange, competitive, cerebral, and privileged.” This description shows that she is both proud and thankful for her experiences, which makes it harder for her to accept her graduate mental decline. Alice tells John that she is aware she doesn’t “have much more time of really being [herself],” indicating that she can feel herself slipping away. This is confirmed by her feelings of “a growing distance from her self-awareness.” Eventually, Alice even begins talking about herself in the past tense, such as when she observes that she “used to be” someone smart and independent. This shows that she has given up on that past self and now only exists in the moment, without her former qualities and personality.
Through Alzheimer’s, Alice loses every facet of her identity, beginning with her hard-won identity as a tenured Harvard professor and research scientist, her identity as a supportive mother and grandmother, and, ultimately, her entire identity as Alice Howland. The true tragedy, however, is that she senses and feels this, but is powerless to stop it. This is shown during her last moment of true lucidity, when she momentarily discovers a “pristine place” in her mind, and is able to say, “I miss myself.”
Loss of Identity ThemeTracker
Loss of Identity Quotes in Still Alice
She was clearly older than forty, but she wouldn’t say she looked old. She didn’t feel old, although she knew she was aging. Her recent entry into an older demographic announced itself regularly with the unwelcome intrusion of menopausal forgetting. Otherwise, she felt young, strong, and healthy.
The emphasis Alice placed on teaching was in part motivated by the belief that she had both a duty and the opportunity to inspire the next generation in the field, or at the very least not to be the reason that the next would-be great thought leader in cognition abandoned psychology to major in political science instead. Plus, she simply loved teaching.
But most of all, they shared a passionate quest to understand the mind, to know the mechanisms driving human behavior and language, emotion and appetite. While the holy grail of this quest carried individual power and prestige, at its core it was a collaborative effort to know something valuable and give it to the world. It was socialism powered by capitalism. It was a strange, competitive, cerebral, and privileged life. And they were in it together.
They’d played this scene out together before, and this was how it ended. John argued the logical path of least resistance, always maintaining his status as the favorite parent, never convincing Alice to switch over to the popular side. And nothing she said swayed him.
She thought about the books she’d always wanted to read, the ones adorning the top shelf in her bedroom, the ones she figured she’d have time for later. Moby-Dick. She had experiments to perform, papers to write, and lectures to give and attend. Everything she did and loved, everything she was, required language.
She’d rather die than lose her mind. She looked up at John, his eyes patient, waiting for an answer. How could she tell him she had Alzheimer’s disease? He loved her mind. How could he love her with this?
In the month since their visit to the genetic counselor, he’d stopped asking her for help finding his glasses and keys, even though she knew he still struggled to keep track of them.
And although the thought of staying on too long terrified her, the thought of leaving Harvard terrified her much, much more. Who was she if she wasn’t a Harvard psychology professor?
She remembered being six or seven and crying over the fates of the butterflies in her yard after learning that they lived for only a few days. Her mother had comforted her and told her not to be sad for the butterflies, that just because their lives were short didn’t mean they were tragic. Watching them flying in the warm sun among the daisies in their garden, her mother had said to her, See, they have a beautiful life. Alice liked remembering that.
Moonlight reflected off her right wrist. SAFE RETURN was engraved on the front of the flat, two-inch, stainless steel bracelet. A one-eight-hundred number, her identification, and the words Memory Impaired were etched on the reverse side. Her thoughts then rode a series of waves, traveling from unwanted jewelry to her mother’s butterfly necklace, traversing from there to her plan for suicide, to the books she planned to read, and finally stranded themselves on the common fates of Virginia Woolf and Edna Pontellier. It would be so easy. She could swim straight out toward Nantucket until she was too tired to continue.
She had no classes to teach, no grants to write, no new research to conduct, no conferences to attend, and no invited lectures to give. Ever again. She felt like the biggest part of her self, the part she’d praised and polished regularly on its mighty pedestal, had died. And the other smaller, less admired parts of her self wailed with self-pitying grief, wondering how they would matter at all without it.
She’d authored well over a hundred published papers. She held this stack of research articles, commentaries, and reviews, her truncated career’s worth of thoughts and opinions, in her hands. It was heavy. Her thoughts and opinions carried weight. At least, they used to.
They talked about her as if she weren’t sitting in the wing chair, a few feet away. They talked about her, in front of her, as if she were deaf. They talked about her, in front of her, without including her, as if she had Alzheimer’s disease.
More and more, she was experiencing a growing distance from her self-awareness. Her sense of Alice—what she knew and understood, what she liked and disliked, how she felt and perceived—was also like a soap bubble, even higher in the sky and more difficult to identify, with nothing but the thinnest lipid membrane protecting it from popping into thinner air.
What she saw in them, she recognized in herself. This was something she knew, this place, this excitement and readiness, this beginning. This had been the beginning of her adventure, too, and although she couldn’t remember the details, she had an implicit knowing that it had been rich and worthwhile.
She wanted to tell him everything she remembered and thought, but she couldn’t send all those memories and thoughts, composed of so many words, phrases, and sentences, past the choking weeds and sludge into audible sound. She boiled it down and put all her effort into what was most essential. The rest would have to remain in the pristine place, hanging on.
“I miss myself.”